ABSTRACT
Background: Acid corrosive injury to stomach is not uncommon in India due to easy availability. Corrosive ingestion results in significant morbidity. We present our experience in surgical management of such cases. The aims and objectives of this study to review the experience of surgical management of gastric corrosive injury and to assess long term outcome and functional results.Methods: This study was retrospective analysis of prospectively collected data of 23 cases of acid corrosive injury managed in a single surgical unit.Results: Median age was 31 years, male to female ratio was 12:11. Surgical procedures were tailored according to extent and degree of stricture. Posterior gastrojejunostomy was done in 8 (38.0%) cases, near total gastrectomy in 3 (14.3%) cases, total gastrectomy and Billroth I in 2 (9.5%) cases each. 4 cases were lost to follow up after preliminary feeding jejunostomy. 2 cases had mortality after feeding jejunostomy. 2 cases were managed successfully without active surgical intervention. All patients undergoing definitive procedure had good results in terms of nutritional status and symptoms of gastric outlet obstruction.Conclusions: The outcome of gastric stricture secondary to acid ingestion can be significantly improved by adequate preoperative preparation and planned approach depending upon type of injury.
ABSTRACT
Background: Post-operative urinary retention (POUR) is a common yet potentially serious morbidity with a reported incidence of 3 to 25%. This study aims to evaluate the effect of Silodosin, a super-selective alpha- 1a adrenergic blocking agent, as prophylaxis for post operative urinary retention in patients undergoing various surgical procedures.Methods: 100 patients were divided into two groups of 50 each. In group 1, patients were given prophylactic silodosin to evaluate its effect in post operative retention of urine and in group 2, patients were not given any medication.Results: In this study, POUR was diagnosed. POUR was higher in the older age group i.e. more in the age group of 41-60 yrs but in group 1, it was less as compared to group 2. POUR rate in general anaesthesia (GA) patients are less (11.1%) in group 1 as compared to (23.6%) in group 2. POUR rate in spinal anaesthesia (SA) patients are more (21.4%) in group 1 as compared (16.6%) in group 2. The total POUR rate in group 1 was lower (14%) as compared to (22%) in group 2.Conclusions: In our opinion patients operated under GA, irrespective of gender and type of surgery will benefit from prophylactic silodosin given in pre-operative period for the prevention of POUR and we highly recommend this. Patients who were operated under SA were not benefitted by giving prophylactic silodosin. Probably this is due to use of long acting spinal anesthetic agent in the form of bupivacaine in our patients.